If you had to guess whether watching too much television, not exercising, or sleeping too little is most likely to contribute to childhood overweight, what would you answer? Few people guess that those children who don't get enough sleep may be more at risk for overweight than if they watch too much television or forgo exercise.

A recent study reported in the International Journal of Obesity studied a group of 422 children between the ages of 5 and 10. Researchers questioned parents about lifestyle habits, such as average amount of time spent sleeping, watching television, and exercising. The study concluded that those who slept only 8-10 hours per night were much more likely to be overweight or obese than those who slept 12 or more hours per night. Children who watched television more than three hours daily were twice as likely to be overweight or obese than those who watched less TV and those who didn't exercise were only somewhat more likely to be overweight - but neither of these had as significant of an impact on body weight as skimping on sleep.

Why is this? Previous research has shown that a lack of sleep is associated with a lower level of leptin, a hormone that helps to reduce hunger, and increased levels of ghrelin, a hormone that increases hunger.

The study authors point out that more research is needed to confirm their findings, since this study was based upon interviews with parents rather than scientific measurements, such as electroencephalograms (EEGs) to measure actual time spent sleeping. That is, parents may have reported time of going to bed rather than time of falling asleep.

The amount of sleep time recommended by the American Academy of Pediatrics varies by age, but in general, 5-6 year olds need 10-12 hours sleep per night. Sleep needs decrease slightly with age; teens need an average of about 9 hours sleep nightly.

Has your doctor told you that your child will outgrow her "baby fat"? While the chubby cheeks and thighs of infancy often slim down after a child starts walking, the longer that she carries excess weight, the more likely she is to be an obese adult. In fact, while an overweight 3 year old has only a 10-20 percent chance of becoming an obese adult, this figure jumps to 80-90 percent for an overweight 11 year old.

A recent British study reported in the professional journal BMJ, tracked almost 6,000 11 and 12 year old children until they completed secondary school. Very few of those who were overweight or obese at the start of the study had reduced weight by the end, suggesting that a high amount of fat at 11 years old is predictive of adult obesity.

This study highlights the importance of asking your healthcare provider to check your child's growth during well child visits and advise you if she is overweight. Early childhood is the best time to instill healthy lifestyle behaviors that will reduce body fat - and keep it off.

If your overweight teen boy doesn't seem interested in participating in a weight loss support group, it may be that the group is mainly comprised of girls, which may not address his concerns. After all, feelings about weight, shape and appearance affect the sexes differently.

And males communicate differently, too. Adolescent boys need a safe place to express themselves openly - using a common language.

If there are no male-based weight loss groups in your community, you might try approaching the school social worker to suggest one.

Studies have shown that no matter how much they have eaten during a previous meal, children tend to overeat if served large portions. This may be because there is a strong human tendency to finish a serving of food, no matter what the portion size.

Researchers at the University of Pennsylvania experimented with a bowl of M&Ms placed in the lobby of an apartment building with a serving spoon positioned next to it. Over the course of time, the spoon was replaced with ones of increasingly larger size.

The researchers found that no matter how small or large the spoon was, passersby tended to take one portion, or a spoonful of candy - and finish it.

This observational study, which was reported in a recent issue of Psychological Science, helps to explain why consumers are influenced by larger portion sizes such as super-sized fries or drinks. Rather than drinking or eating only a normal portion size, people feel compelled to finish the serving.

The message for parents? Learn what constitutes a normal serving size of the foods you give your child - and serve only that.

Obese children have an increased risk for emotional problems that may carry into adulthood. Much of this has to do with being teased about being overweight, which can contribute to low self-esteem and depression. In fact, according to a recent study reported in the Journal of the American Medical Association (JAMA), adolescents who are teased about their weight are more likely to contemplate and attempt suicide.

What are some signs that your child is experiencing emotional distress?

• Decreased interest in activities that he has enjoyed in the past
• Reluctance to make friends, has few friends
• Anxiety or reluctance to attend school
• Appears sad, angry, isolated
• Sleeps too little or too much
• Expresses thoughts of hurting himself

Talk to your family physician if your child has any of these symptoms; she may need help from a mental health specialist to deal with her emotions.

If your child shows an interest and ability in one sport such as ice-skating or dance, should you allow her to pursue this sport to the exclusion of all others?

Maybe not. While specialization in one sport or activity does promote a high level of physical activity, in the long run it may not promote fitness for life. Recently, researchers from Queen's University in Kingston and York University studied the childhood sports experiences of 18 master triathletes, and concluded that children who specialize in one sport early on are not as likely to be active in adulthood as those children who experienced a variety of sports and physical activities.

This may be because training for a specialty sport is more intense and less like play, whereas more low key sports experience is perceived as being fun—which can provide a love of physical activity which may last into adulthood.

Obesity specialist James Levine, a doctor from Mayo Clinic in Rochester, Minnesota, believes that obesity is a direct result of sitting. Recently Levine, with the help of other researchers and the Apple computer company, set up an experimental "chairless classroom" in an effort to test this theory. In this classroom, students aged 10-12 work standing up rather than sitting, although if they become tired, they are allowed a break on a floor cushion.

Levine has spent years studying non-exercise activity thermogenesis (NEAT), which is the energy expended in everyday activities. He believes that energy saving devices such as dishwashers and power mowers have decreased the amount of energy the average person expends daily. Added to the lure of sedentary activities such as television, Gameboys and computers - the result is a more obese population.

Prior to the experiment, Levine predicted that children would use about 3 times as much energy standing to do schoolwork than sitting. And early indications of energy expenditure, measured by "movement detectors" strapped onto the children's arms and legs, bears this out.

While it may be years before Levine's "chairless classroom" concept is embraced in school designs, the idea of allowing children frequent movement breaks during the school day is a healthy one.

It's a well-known fact that lack of sleep reduces alertness and keeps kids from performing well in school. But did you know that people who regularly get less than 8 hours of sleep per night are more likely to be overweight?

Recent studies have shown that even temporary sleep deprivation alters the levels of hormones in the body that regulate hunger. Studying into the wee hours of the night is often followed by a day of craving and consuming calorie dense carbohydrates.

How much sleep does your teenager need? Experts recommend at least 8 1/2 - 9 hours per night and ideally more. Tips for improving sleep include:

• Try to keep a regular bedtime each night, including most weekend nights. Staying up late on weekends and then sleeping in the next morning interferes with regular sleep patterns later in the week.
• Exercise each day, but try to avoid exercise for several hours before bedtime, as this might cause difficulty falling asleep.
• Avoid caffeine in sodas and other drinks late in the day
• Avoid all nighters by studying for exams ahead of time rather than at the last minute.
• Relax the mind before bed with low lighting and soft music or light reading. Avoid homework or scary movies right before bedtime.
• Don’t take weekend naps that are greater than 30 minutes in length

Losing or gaining weight is all a matter of energy balance. To lose weight you need to put out more energy in activity than you take in from food and fluids you consume. And you gain weight if you take in more than you put out.

Have you ever wondered how many calories you burn in activity? A general guideline is that the more you weight, the more calories will be expended. For a 100-pound person, here is the approximate number of calories burned in 30 minutes:

• Sleeping 27
• Reading 30
• Watching TV 30
• Walking (moderate) 75-100
• Playing hopscotch 120
• Skateboarding 150
• Playing softball 150
• Mowing the yard (power push) 165
• Swimming (moderate) 180
• Ice skating 210
• Frisbee 240
• Basketball 240
• Biking (moderate) 240
• Running (moderate) 270-330
• Soccer 300

If you're trying to lose weight, increase the amount of high-energy activities you do throughout the day to assure that you put out more energy than you take in.

Your child is running late for school and he grabs a breakfast bar. It's better than nothing, and it's pretty healthy, anyway, right? It is if it's made from soy, according to a study published in the Journal of the American College of Nutrition.

Researchers from the University of Kentucky found that study participants who ate soy based meal replacement bars and drinks had lower levels of LDL (bad) cholesterol and slightly lower blood sugar values than those who ate milk-based meal replacement foods and drinks. They also lost slightly more weight when the meal replacement products were used for weight loss.

While a diet of a variety of healthy, low fat foods is better than replacing meals with bars or drinks, the message about soy is clear - it may be a valuable tool in maintaining overall health. There are many options for incorporating soy into your diet. Some ideas:

• Use soy milk on cereal or in a fresh fruit smoothie
• Cut up chunks of tofu to add to a stir fry
• Sprinkle soy nuts on salad
• Use soy crumbles in chili, sloppy joes or spaghetti sauce
• Try soy cheese on pizza

A new educational video series addressing the obesity epidemic by focusing on kids talking to kids is making its debut in over 26 states this year. The FUEL™ prevention curriculum developed by the Comprehensive Health Education Foundation (C.H.E.F.) is targeted to children ages 10-18 and profiles real teens who have made positive lifestyle changes and have influenced such change within their communities. In addition to the videos, the curriculum includes ideas for lessons and small-group projects.

The positive student feedback about the FUEL program already received by C.H.E.F. may be directly attributed to the power of peer influence. Peer pressure, as we all know, can be a bad thing. But when used as a force to make positive changes - it can be extremely effective.

For more information on the new FUEL series, visit http://fuel.chef.org.

Kids have their own ideas about how to solve the obesity epidemic. 60 finalists in this years' Young Epidemiology Scholars Competition were asked to brainstorm solutions to the obesity problem, and came up with some creative ideas. Among them:

• A "shock and awe campaign" spelling out consequences of obesity
• Helping people to fill voids in their lives with a passion or hobby - instead of food
• Mandatory participation in sports for middle and high school students
• Banning fast food outlets
• Genetically manipulating taste buds to prefer healthy foods

According to a study in a recent issue of the Archives of Pediatrics and Adolescent Medicine, more than 2.5 million American teenagers are estimated to have impaired fasting glucose, a condition where the body is insulin resistant and which is often a prelude to diabetes type 2. An additional 39,000 are thought to have diabetes type 2.

The cause for this alarming rise? Researchers at the University of Michigan in Ann Arbor believe that obesity may be the culprit. In a study reported in the February issue of Diabetes Care, it was reported that children who are obese have twice the risk of developing diabetes than those of normal weight.

In the past, type 2 diabetes was primarily seen in adults of middle age. This is the time when body weight often rises, and excess pounds contribute to problems with the body's production and use of insulin. But with today's epidemic of overweight and obese children, insulin problems - and type 2 diabetes - are becoming commonplace.

Researchers studying the proximity of fast food restaurants in the Chicago area found that almost 80% of schools were within a half mile of at least one fast food restaurant. Is this by accident? Not according to the study, which was reported in a recent issue of the American Journal of Public Health. Statistically significant clusters of these junk food havens were found within a short walking distance from school, where teens can easily walk to lunch.

If you can't change where your child attends school, work with school officials to prohibit students from bringing fast food to be eaten at school or making these restaurants off limits. The study authors also suggest community zoning requirements limit how close fast food restaurants can be to schools.

You likely remember recess as the most important part of the school day. A chance to get outside and run around, climb the monkey bars, and talk with your friends. Do your children have the same opportunity?

Just at a time that obesity levels among children are climbing, recess is being restricted or even eliminated in many schools. This is often due to Increased pressure for all children to perform well academically and sometimes because of fewer funds for playground monitors.

Recess is as important today as it was 20 years ago. Children need to move their bodies frequently during the day, both for physical and emotional health. Behavior often improves following even a short recess, too.

Some states have instituted policies assuring recess for all elementary school children. Has yours?

Do you know if your child is overweight? Many parents don't, according to a study performed at the University of California, San Francisco. According to study authors, a significant number of Latino women (who were the study participants) failed to recognize their overweight children as being overweight.

According to some doctors, this is true for many parents, not only Latino parents. This may be because of the stigma associated with being overweight and a general reluctance to label a child as being overweight.

How do you find out if your child is carrying too many pounds? Check with your physician. Children's weights are plotted on developmental growth charts adjusted for age and height. Weight should be checked at least twice a year.

While women of all cultures are affected by obesity, there are cultural differences in how a woman views her body size, according to a study reported in the Journal of Advanced Nursing. This makes it more likely that an obese black woman will think of her excess weight as an attractive feature - and not unhealthy. White women, in contrast, view obesity as unattractive and socially unacceptable. But only some of the white women saw obesity as a health concern.

A new American Academy of Pediatrics policy statement implores doctors to work with families and communities to curb the obesity epidemic - especially through school programs. Some of the ways in which doctors are being asked to help is to actively work with the schools to institute healthy lunch programs, develop wellness policies, and institute compulsory physical activity programs.

Doctors are also being called upon to work with parents in checking children's weight regularly and suggesting healthy lifestyle habits, such nutritious diet and regular exercise.

Does your child's school reward the class that read the most books during the "promote reading week" with a pizza party? Are students who achieved the honor roll given an ice cream treat? There are many disadvantages of using food as a reward. Not only does it encourage children to overeat foods high in fat and sugar, it teaches them to eat when they're not necessarily hungry - to reward themselves.

Suggest to your school some alternatives to food rewards. Some ideas:

• Stickers, pencils, or other school supplies
• Watching a video
• Extra recess or art time
• Having the teacher read a special book
• Playing a game as a class